Functional Upper Trap Training

The upper traps are an often misunderstood muscle that gets a bad reputation in rehabilitation. For years many therapists and trainers have taught their patients to bring their shoulders back and down when treating the neck or shoulder girdle. Patients are taught to constantly stretch the upper trapezius muscle and strengthen the lower and middle traps to improve posture and treat conditions such as shoulder impingement. However the upper trap serves an important role in creating scapular upward rotation, which is necessary to fully elevate one’s upper extremity. The upper trapezius works in a synergy with the lower trapezius and serratus anterior to create an upward rotation moment at the shoulder blade. If the shoulder blade does not properly rotate upward when reaching overhead, this can create impingement syndrome. With impingement syndrome muscles such as the bicep and rotator cuff become impinged or compressed at the shoulder joint leading to pain and difficulty reaching overhead. With proper motion at the scapula impingement syndrome can be easily avoided.

Patient’s are often times taught to perform upper trap stretching either from a video they watched on youtube on “4 exercises to get rid of shoulder pain” or by someone treating them. While it is true that some patients have tight upper traps that need stretching; this is not always the case and often times stretching the upper trap can lead to more dysfunction and neck pain. This is why it is important to be properly evaluated by a physical therapist that will know when to stretch and not to stretch a muscle.

Many patients simply do not understand how to use the upper traps. The upper traps can perform a shrugging motion, which is a common exercise performed by body builders at the gym. People who are not body builders may also tend to over-shrug the shoulder when reaching overhead or sitting with poor posture. Shrugging creates scapular elevation without upward rotation which can often lead to impingement of the muscles of the shoulder girdle as well as increase compression to the joints of the cervical spine.

To properly create upward rotation the upper traps must be activated along with the lower traps and serratus anterior muscles. This can be done with a multitude of exercises. An important feature of all the exercises performed for upward rotation is shoulder external rotation. The arms must be rotated so that the palms and pits of the elbows face up. This will help in increasing the activation of the lower traps and serratus anterior which are always more active when the shoulder is externally rotated.

By holding on to a stick or dowel a patient or a client can raise their arms overhead into a “Y” position; while this is done the patient may create external rotation by pretending to break the stick or bar in half. The patient brings their arms overhead by pretending to “lengthen” them into the ceiling which will lead to activation of the upper traps while the scapula is upwardly rotating.

Farmer’s carries are another great and functional exercise that can simulate carrying heavy loads. With this exercise a patient can grab two appropriate barbells or kettlebells; while holding the bells the patient will then try to pull their shoulders out and back while externally rotating the arms until a squeeze is felt by the entire trapezius muscles and serratus anterior. This is a great exercise for neck patients that feel pain when they are required to lift heavy loads.

The upper traps can be trained in a functional way at any point by performing a slight shrug while the scapula is upwardly rotating, so any time the arms are overhead a patient can pretend they are lengthening the arm into the ceiling. This can be done with a weight.

Muscle balance is very important, sometimes a muscle that is often tight can also be weak and improperly used. All muscles including the upper traps serve a function, so they must be trained in a functional way in order to achieve a balance and healthy musculoskeletal system.